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6�ti9 "N WdD:6 SIOZ' 'Z 'Ady awil pania�a� <br /> Inedible Kitchen Grease (YKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Sex-vice <br /> Date: Time: + 4 a-- PNI Manifest#L-0/2 4 <br /> Business Name: Vim' jU 1 l <br /> Job Site Address: Zip de: C <br /> Customer Name (print): (Signature): <br /> 1:G Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whiteslough SPCF <br /> 12751 N. Thornton Rd <br /> Lodi, C,A,95242 <br /> (209) 333-6749 <br /> Date of IKG Receipt, /s Time of IKG Receipt: _ Total lKG Received: <br /> Septic CGrease <br /> Receiving Facili1Ly. (Print)Rep.Name Print .1 UU�(Signature): <br /> b 'J Rep. <br /> Authorized Transporter: 'Vehicle Decal Number: ft <br /> Stockton Roto hooter Driver Name(print): U d��' <br /> 4228 Newton Rd _ _ --- <br /> Stockton,CA 95205 Driver Signature: <br /> l l 'd 8261 'ON WdL�:Z S [06 'Z `gad <br />